What is Plan B and why is the government introducing restrictions again?

UK

‘Plan B’ COVID restrictions could be brought in across England as soon as this week to deal with the spread of the Omicron variant.

In September the government set out its plan for tackling coronavirus over the winter period, with a set of ‘Plan B’ measures to prevent the NHS “coming under unsustainable pressure”.

Professor Neil Ferguson, a member of the Scientific Advisory Group for Emergencies (SAGE), has said cases will peak again in January if no interventions are taken against the new variant and refused to rule out the possibility of another lockdown in the coming weeks.

Despite his denials at Prime Minister’s Questions, Sky News understands that Boris Johnson is “minded” to bring in Plan B in the coming days, fearing that failing to bring in some restrictions now will mean stricter ones in the New Year.

Here we look at what Plan B is and why it is being implemented.

What is Plan B?

As part of its COVID-19 Autumn and Winter Plan 2021, the government outlined a set of measures that would be brought in “if the data suggests the NHS is likely to come under unsustainable pressure”.

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They were drawn up before the Omicron variant and only apply to England as COVID restrictions are devolved to the Scottish and Welsh governments and Northern Ireland Executive.

The plan claims that with most adults having “high levels of protection” from vaccines “relatively small changes in policy and behaviour could have a big impact on reducing transmission”.

Those changes include:

  • Introducing vaccine-only COVID passports in “certain settings”
  • Making face masks a legal requirement in “certain settings”
  • Asking people to work from home, if they can, for a “limited period”
  • Communicating “clearly and urgently” that the level of risk from COVID has increased, resulting in a “need to behave more cautiously”

Face masks are already a legal requirement in shops, banks, post offices, hairdressers and on public transport as of 30 November.

But this would be extended to more indoor settings, as all hospitality venues, including restaurants and bars, are currently exempt.

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Why is it being brought in now?

Professor Neil Ferguson, the epidemiologist who helped formulate plans for the first lockdown, has told the BBC that introducing more restrictions would “slow down” another wave of cases from Omicron and would “buy us more time to get boosters into people’s arms”.

But Dr Chris Papadopoulos, principal public health lecturer at the University of Bedfordshire, warned that vaccines alone will not protect people against the new variant.

“The government puts a real emphasis on vaccination in their Plan B, but we don’t yet know the degree to which Omicron evades vaccines,” he told Sky News.

“So it’s not as simple as vaccines only.

“We cannot allow a significantly mutated version of the virus like this to run free in our society when we don’t understand it yet – it’s not the ethical thing to do.”

He added that social distancing will be key in reducing transmission in the coming weeks.

“This is a reminder that vaccines are effective, but they aren’t our only defence,” he said.

“The biggest defence against an airborne, respiratory virus is social distancing, because if you’re distanced from someone the virus cannot transmit.”

On the timing of Plan B, Dr Mike Gill, former regional director of public health for the South East, added: “You don’t wait until it’s too late in this kind of situation. There’s too much uncertainty and too much risk if you don’t act early.”

Hospital admissions ‘single most important thing’

According to its winter plan, the government says the purpose of Plan B is to stop the NHS being overwhelmed.

Dr Simon Kolstoe, reader in bioethics at the University of Portsmouth, stressed that the aim of restrictions is keeping COVID hospitalisations down – not the number of cases.

“The single most important thing to consider here is what is going to happen in hospitals – particularly in intensive care,” he told Sky News.

“If a peak in hospital admissions is going to come in January, then it makes sense to put measures in place to stop that peak from happening.

“We have to do things two, three or even four weeks in advance – because the earlier we put things in place, the better position we will be in.”

Dr Papadopoulos added that although COVID-related deaths have been falling in recent weeks, they are up 3% over the past seven days.

“In the last couple of days that downward trend has been changing,” he said.

“With deaths there’s always a two-to-four week lag. And with a mutated version of the virus like this, we should expect to see an increase in deaths and hospitalisations.”

Will Plan B work?

Scientists do not yet have enough real-world data to know how well vaccines, and particularly booster doses, will protect against Omicron.

Dr Gill says that data will be key in deciding whether stricter restrictions, such as the lockdown we saw last January, are necessary.

“The lesser protection from vaccines we have the bigger the overall interventions have to be,” he said.

Dr Peter English, former chair of the British Medical Association’s Public Health Medicine Committee, warns that the NHS “is in a dreadful state now” and “we must do all we can to protect it”.

He says this should mean a “Plan B plus” being introduced that goes beyond current proposals.

“We know that the third dose leads to a very large increase in antibody levels, but it will take time for everybody to have had three doses,” he wrote on Twitter.

“In the meantime… it is vital that we maintain non pharmaceutical interventions.

“Wear a mask, reduce the amount of contact you have with others, ideally avoid parties and unnecessary gatherings.

“If you can’t avoid contact with other people, make sure you wear a mask, keep it as brief as possible and do a test before you meet up.”

Dr Gill also warns of the effects that reports of a Downing Street Christmas party amid last year’s restrictions will have on compliance.

And he says that existing issues with Test and Trace will need to be addressed to ensure people follow the rules.

“There was nothing in Plan A about increasing support for people self-isolating,” he said.

“The biggest non-pharmaceutical intervention you can make is reducing social contact – and working from home is a big part of that.

“But that is regressive and discriminatory unless you support the people for whom that is difficult.”

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